Polymicrogyria in a fetus with human parvovirus B19 infection: a case with radiologic-pathologic correlation.

We report the prenatal magnetic resonance imaging (MRI) appearance of polymicrogyria with pathologic correlation in a fetus with congenital parvovirus B19 infection. Prenatal ultrasound revealed non-immune hydrops, but detected no fetal brain abnormalities. A subsequent fetal MRI scan performed at 23 weeks' gestation demonstrated bilateral polymicrogyria, which was confirmed at autopsy.

Detection of occult melanoma by preoperative positron emission tomography-computed tomography and intraoperative ultrasonography.

Background: 18F-Fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) has become a common imaging modality for detecting metastatic melanoma. However, the identification of lesions intraoperatively can be difficult.

Objective/methods: We describe an innovative multimodality approach to tumor localization using preoperative PET-CT and intraoperative ultrasonography and describe cases in which this technique was used.

The yolk stalk sign: evidence of death in small embryos without heartbeats.

Objective: The purpose of this study was to assess the positive predictive value for confirming early embryonic death in the clinical sonographic scenario wherein an embryo is identified without a visible heartbeat; the embryonic crown-rump length (CRL) is 5 mm or less; and the embryo is not immediately adjacent to the yolk sac.

Methods: A retrospective study of 882 first-trimester sonograms was performed among women who had an intrauterine pregnancy of uncertain viability based on 1 or more sonographic findings (eg, no visible heartbeat in an embryo with a CRL of < or =5 mm). Eight hundred six cases met the inclusion criteria.

Evaluation of diffuse liver steatosis by ultrasound, computed tomography, and magnetic resonance imaging: which modality is best?

Purpose: To compare ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) determination of diffuse liver steatosis.

Materials And Methods: Quantification of liver steatosis on ultrasound, CT, and MRI was correlated with histopathology in 67 patients.

Results: Opposed-phase MRI demonstrated the highest correlation with steatosis (0.

Magnetic resonance imaging and hysteroscopy to diagnose colo-uterine fistula: a rare complication of diverticulitis.

Colo-uterine fistula of diverticular origin is an extremely rare disease due to the resistance of uterine tissue. Methods for diagnosis remain to be established. Non-invasive imaging like magnetic resonance imaging (MRI) may help to establish a proper diagnosis, but confirmation may be reached by diagnostic hysteroscopy or even surgical exploration.

Columns of the fornix, not to be mistaken for the cavum septi pellucidi on prenatal sonography.

Objective: Visualization of the cavum septi pellucidi (CSP) is considered an integral part of the prenatal second-and third-trimester sonographic evaluations of the fetal neural axis. We have noted that another anatomic structure, the columns of the fornix, can be mistaken for the CSP and result in the missed diagnosis of agenesis of the corpus callosum.

Methods: We describe a case in which the columns of the fornix were misinterpreted as representing the CSP during a sonographic evaluation at 18 weeks' gestation.

Fetal cerebellar hemorrhage in parvovirus-associated non-immune hydrops fetalis.

We report two cases of fetal cerebellar hemorrhage in the setting of parvovirus-associated hydrops fetalis and fetal blood transfusion. In both cases, the cerebellar hemorrhage was diagnosed by fetal magnetic resonance imaging after intrauterine blood transfusion. To our knowledge, this is the first report of fetal cerebellar hemorrhage in the setting of parvovirus-associated hydrops fetalis, and may be the result of cerebrovascular changes both during and after the transfusion.

Reliability of the lung-to-head ratio as a predictor of outcome in fetuses with isolated left congenital diaphragmatic hernia at gestation outside 24-26 weeks.

Objective: The purpose of this study was to investigate the relationship between lung-to-head ratio (LHR) and gestational age (GA) in fetuses with isolated left congenital diaphragmatic hernia and to determine the applicability and reliability of LHR to predict postnatal outcome beyond 24-26 weeks of gestation.

Study Design: The institutional review board approved this retrospective review of the University of California, San Francisco, Fetal Treatment Center database for cases with left congenital diaphragmatic hernia who were referred between March 1995 and June 2004. LHR was determined at the initial evaluation.

Unusual presentation of 22-kilogram retroperitoneal müllerian serous cystadenoma.

Background: Müllerian cyst of the retroperitoneum is an extremely rare disease that is thought to be a subtype of urogenital cyst. It is a benign condition that can only be diagnosed and cured by surgical resection.

Case: An 80-year-old female with a huge cystic swelling, thought to be ovarian in origin, underwent laparotomy.

Evaluation of femur length during the second and third trimesters in fetuses with myelomeningocele.

Objectives: To determine if the femur length of fetuses with myelomeningocele is shorter in the second and third trimesters compared with that of normal fetuses.

Methods: We retrospectively collected measurements of femur length, head circumference, biparietal diameter and abdominal circumference from detailed obstetric ultrasound studies performed during the second and third trimesters in 31 fetuses with myelomeningocele and 43 fetuses with no detectable anomaly. The gestational age predicted by each parameter (based on Hadlock's tables) was compared with the true gestational age (based on last menstrual period), using the ANCOVA test to determine if there was a statistically significant difference between the two groups of fetuses.

Intraventricular hemorrhage in term neonates caused by sinovenous thrombosis.

The cause of intraventricular hemorrhage in term neonates is poorly understood. Among 29 neonates of at least 36 weeks' gestation with intraventricular hemorrhage, 9 (31%) had cerebral sinovenous thrombosis. Of the 26 neonates who underwent computed tomography or magnetic resonance studies, those with thalamic hemorrhage were more likely to have sinovenous thrombosis than those without thalamic involvement (4/5 vs 5/21, p = 0.

The lung-to-head ratio and fetoscopic temporary tracheal occlusion: prediction of survival in severe left congenital diaphragmatic hernia.

Objectives: To evaluate the reliability of sonographic lung-to-head ratio (LHR) measurement as a predictor of survival in fetuses with congenital diaphragmatic hernia (CDH) and to compare the probability of survival in those with temporary tracheal occlusion (TO) or standard care with respect to the LHR.

Methods: Fifty-six fetuses with left CDH with liver herniated into the thorax at complete prenatal evaluation were included in logistic regression analyses of antenatal predictors of survival to hospital discharge. Sixteen subjects underwent TO and 40 received standard care.

Sonographic detection of gallbladder duplication: two cases discovered in utero.

Objective: To report the in utero diagnosis of a duplicated gallbladder.

Methods: Obstetric sonography was performed at 2 separate referral centers. A comprehensive level 11 examination was performed at each center.

Sonographic evaluation of liver nodularity: Inspection of deep versus superficial surfaces of the liver.

Purpose: We determined the diagnostic performance of assessing the nodularity of deep versus superficial surfaces of the liver as a predictor of cirrhosis.

Methods: One sonologist retrospectively reviewed the sonograms of 100 patients at risk for cirrhosis based on clinical data and laboratory tests. A second sonologist reviewed the sonograms of a subset of 25 patients to assess for inter-reader variability, while the first sonologist re-reviewed the sonograms of a different subset of 25 patients for intrareader variability.

Successful fetal intervention for congenital high airway obstruction syndrome.

Introduction: Complete congenital high airway obstruction syndrome (CHAOS) usually leads to stillbirth or death within minutes of delivery. We describe the management and long-term follow-up of a baby with a prenatally diagnosed airway obstruction.

Case: Because of progressive hydrops fetalis, massive ascites and everted diaphragms due to CHAOS in a fetus at 24 weeks of gestation, a fetal tracheostomy was performed.

Measurement of endometrial thickness at US in multicenter drug trials: value of central quality assurance reading.

Purpose: To assess the value of central quality assurance (QA) reading of transvaginal ultrasonographic (US) images obtained to measure endometrial thickness and to assess image quality.

Materials And Methods: Results of 2,000 US examinations performed in 1,000 subjects during one of two multicenter drug trials were evaluated. Endometrial thickness was measured at the study site; images were then sent to the QA center, where an experienced sonologist evaluated endometrial thickness and image quality.

Effect of ultrasound transducer frequency on the appearance of the fetal bowel.

We evaluated how ultrasound transducer frequency affected the appearance of the fetal bowel. One hundred women with singleton pregnancies, who were undergoing routine ultrasonographic examination, were assessed at a single institution. Patients with known fetal anomalies, abnormal biochemical screening results, or a history of cystic fibrosis were excluded.

Chorioamniotic separation after second-trimester genetic amniocentesis: importance and frequency.

Purpose: To determine the frequency and importance of chorioamniotic separation (CAS) after second-trimester genetic amniocentesis.

Materials And Methods: In part 1 of the study, ultrasonography (US) databases were reviewed for cases of CAS. In part 2, a study population of 388 women undergoing amniocentesis underwent directed US examination for assessment of CAS 15 minutes and/or 2 weeks after amniocentesis.

Systemic spread of meconium peritonitis.

Meconium peritonitis is a chemical peritonitis which occurs following bowel perforation during fetal life. It is generally looked upon as benign, resulting in no long-term sequelae. We present a case of a newborn infant with meconium peritonitis who developed infarcts in several organs.

The effect of oligohydramnios on detection of fetal anomalies with sonography.

Objective: The sonographic examination of fetuses is generally thought to be compromised when oligohydramnios is present because of the subjective impression of less adequate visualization of fetal anatomy. The aim of this study was to evaluate the extent to which oligohydramnios limits our ability to detect major anomalies on sonograms.

Materials And Methods: Records from the University of California, San Francisco from March 4, 1989 through January 4, 1994, were reviewed to identify all cases of premature rupture of the membranes in patients who then underwent nontargeted sonography.

Evaluation of a sonographic PACS in clinical practice: analysis of technical and analytical time savings.

The aim of this study was to generate quantitative data regarding technical and analytical time savings obtained by use of an ultrasonographic PACS. Data/time cards were recorded for each patient encountered in an outpatient diagnostic ultrasound facility for a 4 week period immediately before and a 1 year period after installation of a PACS environment. Use of a sonographic PACS resulted in a per case time savings of 293 s in the technical component and 51 to 63 s in the analytical component of an average ultrasonographic examination.